A Response to the New York Times

The New York Times editorial regarding the Baucus plan and health care reform is an incredible piece of work. The Times lost any credibility it had a long time ago, but some people still read the rag and actually subscribe to its beliefs, so it's important to take this editorial apart and clarify things.

The first paragraph set the tone of the piece, closing with this sentence: "Only one Republican on the committee seems open to voting for the bill, and the entire Republican Congressional leadership seems determined — for ideological and partisan reasons — to torpedo the entire reform effort."

The same message concludes the editorial: "Republicans have yet to make any serious counterproposals...".

Both statements are inaccurate. Republicans are not against Obamacare for partisan reasons. Republicans are against Obamacare because the proposals have been lacking in important elements like tort reform, they've been expensive, and they all will impose heavy taxes on all Americans and lead to nationalized health care. The Republicans HAVE offered constructive alternatives such as tort reform and selling insurance across state lines, both of which would make tremendous improvements to what we have now and yet cost the taxpayer nothing.

It should also be noted that The Times refers to the Baucus plan as a bill, yet the plan is not yet in legislative language and is not yet a bill, really. We don't actually know what it's going to say in the end. Or what it will cost.

The Times points out that "Revenue from proposed new taxes and savings from slowing the growth of Medicare costs would more than make up for the cost of covering some 29 million uninsured people" but who is going to pay the price of that Medicare cut? Our seniors, of course. Jeffrey H. Anderson, writing at NRO, says that the Baucus plan will "gut Medicare Advantage and would cut a total of $404 billion from Medicare and related federal health programs in its first ten years alone."

We already know one way those cuts will come - through rationing, as explained here. Every year those that exceed the "resource use" will be fined. Each year the top 10% of offenders will be fined. Every year.

The Times celebrates the fact that the Baucus plan will raise money "by imposing fees on health care providers" but who will really pay that money? Will health care providers really eat that increase or will they pass it on to you? That, combined with other provisions in the Baucus plan, will cause premiums to skyrocket.

Go back to Anderson at NRO who explains: "If you were an insurer and the bill were to pass, I suspect you'd do one of two things: You'd either raise premiums dramatically for the vast majority of people who are generally healthy — knowing that you'd have to charge the same premium to those who aren't, or you'd find a new line of work." Because all plans require insurers to accept all applicants despite any preexisting conditions, insurers are going to have to cover their liability by charging everyone more.

Ultimately many private insurers are going to close shop leaving a large number of Americans shopping for a new plan or forced into a government plan.

Another troubling aspect, to my mind, is that everyone will be forced to have insurance or else pay a fine. In a free society this seems troubling. I'm not sure it's even legal to force someone to buy something they may not want. At any rate, The Times lauds the plan's scheme to soak the rich when they say, "Near-universal coverage is also needed to provide a large risk pool in which the premiums from healthy people on the exchanges can help subsidize the premiums of sick people."

In the opinion of The Times, it seems that the perfect plan would be paid for by the rich and by the elderly, would cover every single American, do nothing about tort reform, and shut down private insurers.

The loophole regarding illegals continues to gape open as the provision to verify legal residency was beat down. It's all well and good to say that no illegals will be covered, but if you don't know and you can't verify, what's the stop-gap going to be?

Despite The Time's giddy glee over the CBO report and the progress of the Baucus plan, there is still much work to do and the best plan would be to start over and listen to some of the Republican ideas which The Times remains deaf to; tort reform, portability, tax credits, and incentives for healthy lifestyles all would go further to creating a more palatable plan than anything Congress has done so far.

Update: Via Memeorandum, here is an analysis from the Washington Examiner.

Starting the Day Under a Cloud

This is the most depressing thing I've read since, well, yesterday. Why does it continue to shock and depress me that the left wants to ruin this country?

The voices on the right, of conservatism, and of the majority of Americans could not be more clear - we don't want Obamacare. Yet Harry Reid and company are intent on jamming it upon us no matter what.

Despite the CBO analysis, which Professor Jacobson points out, is not even in legislative language yet and therefore can't really be properly scored, there are plenty of other reasons to hate this legislation. Foremost in my mind is that it is simply going to lead to inferior care. Every plan on the table so far reduces the level of care you currently receive. The Baucus plan will lead to long waits and deferred care - rationing.

The justification for all this just isn't there. The left screams about all those that are uninsured but many of them choose to be.

The arguments have all been made and I can't make them more forcefully now than I could in the months I've been writing about it. And by the looks of this Foundry post, there's no point anyway. It's a done deal.

So now I have to take my disgust and disillusion out on those lame, weak, bottom feeding members of Congress from both Houses and reject almost all of them. There are no Republican leaders there fighting hard enough for me. Oh, the occasional weak, wishy-washy patsy will amble up to a microphone and give some little self-righteous speech about how this is a travesty but he's not doing much else about it.

In 2010 we need to clean house and get some real leaders in there, if there are any to be found, and take this country back. It's going to take years to undo the damage that's been done already and if Obamacare passes, we're screwed.

Damn, that's a gloomy way to start the day. So sorry.

News Flash:

Professor Jacobson reminds you that THERE IS NO BAUCUS BILL!!

The Baucus Bill is All About Rationing

The Wall Street Journal today highlights a provision in the Baucus bill which is actually frightening and could not make more clear that Obamacare will lead to rationing despite what he says:

"Take a provision in the Baucus bill that would punish any physician whose 'resource use' is considered too high. Beginning in 2015, Medicare would rank doctors against their peers based on how much they cost the program—and then automatically cut all payments by 5% to anyone who falls into the 90th percentile or above. In practice, this rule will only apply to specialists."

What is "resource use?" The WSJ explains that each year Congress allots "x" number of Medicare dollars to doctors. Period. Divide it up between all services. How much one area of billable service gets is called a Relative Value Unit, for example, "in 2008, a colonoscopy earned 5.64 of these units, a hip replacement 37.66. Then it multiplies a doctor's total RVUs by some dollar factor, currently about $36, and cuts a check."

But, under the Baucus bill, "The basic tools of heart specialists—echocardiograms (stress tests) and catheterizations—are slashed by 42% and 24%, respectively." That equals rationing. If this patient needs that test maybe more than you might, you have to wait, because I'm not going over my RVU and getting fined!

Oncologists? Forget it:

"Cancer doctors get hit because the Administration believes specialists order too many MRIs and CT scans. Certain kinds of diagnostic imaging lose 24% under new assumptions that machines are in use 90% of the time, up from 50%. There isn't a radiologist in America running an MRI 10.8 hours out of 12, unless he's lining up patients on a conveyor belt. But claiming scanners are used far more often than they really are lets the Administration "score" spending cuts."

Brian Faughnan, writing for Red State, last week points out that these penalties would apply each year. Every single year the top ten percent of offenders would get penalized.

Faughnan also worries about how these cuts will affect treatment for seniors. Wouldn't they be the first to be denied tests?

The National Right to Life Committee has the same concerns: “This provision does not link funding to outcomes or quality; instead, it will force a ‘race to the bottom’ with relentless pressure on doctors to limit health care for their older patients,” the group said. “On top of the significant Medicare cuts in the bill, this will gravely endanger the lives of America’s senior citizens.”

Faughnan lists those who voted to keep this provision in the Baucus bill:

The Senators who voted to keep this provision are:

Max Baucus, MT

Jay Rockefeller IV, WV

Kent Conrad, ND

Jeff Bingaman, NM

John Kerry, MA

Blanche Lincoln, AR

Ron Wyden, OR

Charles Schumer, NY

Debbie Stabenow, MI

Maria Cantwell, WA

Bill Nelson, FL

Robert Menendez, NJ

Tom Carper, DE

So basically, as the Washington Times pointed out on September 25, if a doctor orders an expensive, life-saving treatment, he is likely to be fined for it, no matter how successful it was or how important it was to saving a life. The incentive is to keep costs down, order fewer tests, and stay out of that top ten percent.

As it stands now, the Baucus bill has been put on hold awaiting scoring by the CBO. Hot Air reports that "Democrats had tried to push the bill out of committee before the Congressional Budget Office could review the proposal and project its costs, fearing that another harsh analysis could kill the Senate effort before it has a chance for a floor vote. " It isn't likely to score well.

Obama can suit up all the actors in white coats that he wants to, it won't change the fact that Obamacare is all about controlling costs and not at all about health care. And that means rationing.

(More at Memeorandum)